A 59-year-old woman with a 10-year history of type - jcbc

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A 59-year-old woman with a 10-year history of type 2 diabetes mellitus is noted
by her physician to have bilateral pitting edema of the ankles
and feet. No erythema is noted. On questioning, the patient also reports
shortness of breath on exertion and states that she has been using 3
pillows at night in order to sleep comfortably.
Question 1 of 6
This patient's symptoms are most suggestive of which of the following?
/ A. Cellulitis
/ B. Congestive heart failure
/ C. Gynecologic cancer
/ D. Lipedema
/ E. Thrombophlebitis

Question 2 of 6
A chest x-ray film demonstrates pulmonary venous congestion and interstitial
edema indicative of pulmonary edema. Which of the following
physiologic mechanisms is most likely the immediate cause of the pulmonary
edema?
/ A. Damage to endothelial cells
/ B. Damage to the epithelial lining of the alveoli
/ C. EIevated pulmonary capillary pressure
/ D. Low serum albumin
/ E. Poor lymphatic drainage of fluid

Question 3 of 6
A chest x-ray film additionally demonstrates a markedly enlarged cardiac shadow
with dilation of both the right and left ventricles.
Echocardiography shows dilated, hypokinetic ventricles. The physician
prescribes several medications, including captopriI. Which of the
following best characterizes captopriI?
/ A. ACE inhibitor
/ B. AIpha blocker
/ C. Beta blocker
/ D. Diuretic
/ E. Positive inotrope

Question 4 of 6
An increase in which of the following is the most likely explanation for the edema
in her legs?
/ A. Interstitial colloid osmotic pressure
/ B. Lymph flow
/ C. PIasma colloid osmotic pressure
/ D. Right atrial pressure
/ E. Stroke volume

Question 5 of 6
As this patient's condition progresses, she is started on digoxin. Her most recent
digoxin blood level was 2.0 ng/mL. She will be at the highest
risk for developing digoxin toxicity if she has which of the following conditions?
/ A. Hypokalemia
/ B. Hyponatremia
/ C. Hypophosphatemia
/ D. Vitamin B12 deficiency
/ E. Vitamin K deficiency

Question 6 of 6
This patient's condition is associated with which of the following 5-year mortality
rates?
/ A. 5%
/ B. 30%
/ C. 50%
/ D. 70%
/ E. 95%